Text Messaging Program Could Increase Adherence to Buprenorphine Treatment

Researchers are testing whether a text messaging system can increase patient adherence to buprenorphine treatment for opioid addiction.

“We use text messaging in our society for so many things, but for something as critical as opioid treatment, we really didn’t have any text messaging system to support patients,” said lead researcher Babak Tofighi, M.D. Assistant Professor in the Department of Population Health at NYU Langone Medical Center.

Dr. Tofighi works with patients at Bellevue Hospital, many of whom do not have access to smartphones. “Text messaging can reach people at all income levels, with all sorts of phones, even basic ones,” he said. “The patient population we are targeting may not have iPhones, but they can receive texts. Even a simple reminder hopefully could increase adherence to treatment and reduce overdoses and relapses.”

About half of patients drop out of buprenorphine programs because of administrative issues – ranging from lack of insurance coverage to transportation costs, Dr. Tofighi said. “If we could have a text messaging intervention to help them deal with administrative hurdles, it could really help them stick with treatment,” he said.

The text messaging system, which is still being refined, sends content to motivate patients to stick with their treatment. It also texts reminders for appointments, and tells patients who to text if they have unanticipated issues that are interfering with getting treatment. “It’s like an emergency line for when hospital staff or operators can’t help the patient out,” Dr. Tofighi said.

If the patient texts a question asking for resources—such as treatment for hepatitis C, or where to find a 12-step group—the system will send back an automated response with answers. If the patient has a more complicated issue, the system will alert the doctor, who will call the patient.

Currently the system is being tested by 20 patients. “We’re asking patients weekly about how many messages they get, how useful they are, and whether they are confusing. Are we sending them at the right time, and are we sending enough of them?” The researchers are also working to tailor the program to specific populations, such as patients with HIV, hepatitis C and mental health issues.

Once the researchers have fully developed the texting system, they hope it can be rapidly scaled up nationwide. Dr. Tofighi said the final product is expected to be available by next winter. The researchers are also working with colleagues in Puerto Rico and Colombia to develop a Spanish version.

“Our goal is to have this program used by any system dealing with vulnerable populations, including rural community health centers, the VA health system or Indian reservations,” Dr. Tofighi said. “A lot of doctors doing addiction medicine don’t have a lot of administrative support, and we want to help them.”

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